Exercise as a Vital Sign

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Since May is National Physical Fitness and Sports Month, we were reflecting on a meeting at the Center for Total Health a couple years ago with the American College of Sports Medicine (ACSM) to address key issues related to establishing a physical activity prescription at every visit as a medical standard of care. Kaiser Permanante’s own Robert Sallis, MD, was in attendance and helped lead a walking break to visit the Supreme Court.

A lot has happened since that meeting. A white paper was published summarizing the call to action and an article was published in the American Journal of Medicine on June 3, 2016. Vital signs such as blood pressure, heart rate and other metrics are used to understand the potential root of health issues. They can inform clinicians about the likelihood of future diseases and your potential health status. Smoking, tobacco use and other metrics have been used as predictors of health for years.

Several large health systems are now monitoring physical activity as a vital sign, including Kaiser Permanente, Intermountain Healthcare (UT), and Greenville Health System (SC). The process is simple. A health care team member asks two questions: 1) On average, how many days per week do you engage in moderate-to-vigorous physical activity? And, 2) On average, how many minutes do you engage in physical activity at this level?Rx pad 1

“As a physician, we know simple steps can have a huge impact on someone’s health,” Sallis said. “You don’t have to join a gym or commit significant amounts of time to exercising. Physical activity is about movement and that movement can make all the difference on your long-term health.”

This more proactive approach offers patients a chance to partner with their care provider on more personalized interventions to improve their health, Sallis said.

Kaiser Permanente of Southern California recorded and 85 percent capture rate for 2.1 million members during the first year. The experience at Kaiser Permanente and other health care systems shows that physical activity can be captured by any medical assistant or member of the care team as part of the routine vital signs process.

“We are currently working with the ACSM and Exercise is Medicine initiative to establish exercise as a vital sign (EVS) around the world. At Kaiser Permanente, we’re proud to be a leader in this space,” Sallis said. “Currently, more and more health care organizations are adopting EVS and we are working on establishing a HEDIS measure around assessing exercise in adults.”

 

New Perinatal Depression Display

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mother-child-iconPerinatal depression occurs in 12-20% of all pregnancies and can include premature delivery, decreased maternal-child interactions, child behavior problems and, in severe cases, suicide or infanticide.  Through Kaiser Permanente of Northern California’s Universal Perinatal Depression Screening Program, all women are screened with a nine-question survey called the PHQ-9 three times during the prenatal period. Each woman’s obstetrician reviews the results and, when depressive symptoms are present, offers treatment and referrals for classes, support groups, individual counseling or prescription medication.

Results:

  • Screened 98% of pregnant and postpartum women at least once during and after pregnancy, compared to less than 1% prior to implementation
  • Increased rate of new depression diagnoses to 12%, compared to 8% prior to implementation
  • Provided treatement to 82% of women with severe depression, compared to 5% prior to implementation.

For more information on the program, visit the center to see other displays on innovative programs or read the full story on KP Share.

Q&A with Kaiser Permanente Chairman and CEO Bernard Tyson on Mental Health

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Kaiser Permanente Chairman and CEO Bernard J. Tyson discussed mental health, the social determinants of health and Kaiser Permanente’s always-active expansion strategy with Southern Bureau Chief Dave Barkholz in San Francisco. To read an edited transcript, click here.

Kaiser Permanente, the nation’s largest integrated health system, has made mental-health awareness a priority, as it seeks to promote the total health of the individuals and communities it serves. Even though depression and other mental health issues are common, they can be difficult to talk about. Kaiser Permanente’s “Find Your Words” public health awareness campaign focuses on TV, radio and online messages that talk about depression in an honest and inspiring way.

Kaiser Permanente Launches ‘Find Your Words’ Campaign to Fight Stigma Around Mental Health

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Kaiser Permanente’s “Find Your Words” public health awareness campaign focuses on TV, radio and online messages that talk about depression in an honest and inspiring way. Coinciding with the start of National Mental Health Month, the campaign launched Monday, May 1.

In addition to the “Find Your Words” campaign, Kaiser Permanente Colorado awarded grant funding to advance social and emotional wellness and mental health in school districts across the state. In August 2017, Kaiser Permanente will award five Colorado school districts a combined $1.5 million in Thriving Schools behavioral health grants.

The schools will use the grants to increase access to mental health and wellness programs to help teachers and staff learn how to identify and deal with mental health needs in students as well as themselves.

You can read more about the Find Your Words campaign and learn more about the grants KP Colorado awarded here. 

Four Ways the Health Care Industry Can Help Green the Planet

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Earth Day 2017 is April 22, a good time to consider the many ways both individuals and organizations can take steps toward greening the planet — whether it’s opting for products made without harmful chemicals, setting up workplace compost programs, or investing in renewable energy sources.

Kaiser Permanente, the largest integrated health care system in the U.S., is one organization that is leading by example with its dedication to environmental stewardship.

“We understand the clear connection between a healthy environment and the health of individuals,” said Kathy Gerwig, vice president of employee safety, health and wellness, and environmental stewardship officer at Kaiser Permanente. “Preventing environmental causes of illness is the main objective of our sustainability program. We also recognize that the health care industry’s impact on pollution and waste is substantial, and we want to be proactive in combatting it.”

Among the ways health care organizations can help green the planet:

  1. photo of solar panels on top of a buildingEmbrace renewable energy. Green power sources, including solar and wind energy, are more accessible than ever. Rooftop solar installations and large-scale wind farms are two of many available options. In 2016, 46 percent of the electricity Kaiser Permanente used in California came from renewable resources.
  2. Insist on better products. There may not be room in the budget to buy exclusively sustainable products, but organizations can focus on certain areas that will make a big difference, such as more efficient electronics. Kaiser Permanente recently earned the EPEAT Purchaser Award for buying greener electronics in 2016. Over its lifetime, this equipment will result in a number of environmental impact reductions, including avoiding the disposal of 124 metric tons of hazardous waste — equal to the weight of 1,009 refrigerators.
  3. photo of women shopping at a farmers marketEat what you preach. The industrial food chain can negatively impact health, exposing workers and consumers to harmful chemicals and creating pollution when food is transported long distances. Locally grown, sustainably farmed and processed food choices are good for the environment and for individual health. To this end, Kaiser Permanente buys nearly 25 percent of its food sustainably, and aims to raise that number to 100 percent by 2025.
  4. Set a goal and strive to reach it. Starting with small behavioral changes can make a big difference, but having an ambitious goal to aim toward can also be a great motivator for significant change. Kaiser Permanente has set ambitious sustainability goals to meet by 2025, including recycling 100 percent of non-hazardous waste, reducing water use by 25 percent per square foot of building space, and becoming carbon net positive.

Thanks to Kaiser Permanente Share for providing this blog.

Why Talking About Depression Is a Radical Act

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Depression is a topic that remains shrouded in silence, yet it’s a condition that has touched millions of people. One in five adults experience mental health issues in a given year. One in five youth experience a severe mental health condition at some point during childhood or adolescence.

WHOgraphic_stairs_274x168Still, over the last century, depression has been one of the great unmentionables. But there is hope. To bring depression out of the shadows, we just need to talk about it.

That’s where two complementary public health awareness campaigns come in — the first by the World Health Organization and the other by Kaiser Permanente. The WHO’s “Depression: Let’s Talk,” and Kaiser Permanente’s “Find Your Words,” focus on addressing and reducing stigma through conversation and dialogue.

Read more of this article here. 

Tapping the Power and Potential of Technology Together

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Digital technology is revolutionizing our world in ways we are only beginning to realize. Recently Kaiser Permanente Chairman and CEO Bernard J. Tyson joined other CEOs and global leaders to welcome the World Economic Forum’s Center for the Fourth Industrial Revolution to San Francisco — a fitting location for a global center committed to ensuring that advances in technology, science and medicine serve humanity and foster the universally held values of equality, connectedness and peace.

World-Economic-Forum-feature-274x168As a founding partner of the center, Kaiser Permanente will actively use this platform to collaborate with policymakers, technology leaders, influencers and others to tap the power and potential of technology to transform health care. Specifically, we will explore opportunities related to such things as artificial intelligence, the internet of things, precision medicine, data sharing and ownership, etc., while also working to resolve the ethical and practical concerns these advances in science and technology create.

Watch the video introducing the Center for the Fourth Industrial Revolution.

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Taking Bids on Hospital of the Future

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garfieldAs Silicon Valley’s main hospital system and insurer, KP has been working with tech companies to respond to patient demands, and supply what the organization envisions it may need in the near future. Much of the testing is happening at the Garfield Innovation Center in San Leandro, California.

Kaiser Permanente Chairman and CEO Bernard J. Tyson sat down with Bloomberg Businessweek writer Caroline Chen to talk about the hospital of the future.

Read the Bloomberg story here. 

Virtual Care Lets Physicians Provide Care Anytime, Anywhere

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The world of health care is changing. Telehealth options such as video visits, phone visits, and email consultations are growing in popularity. Today, out of more than 100 million encounters with Kaiser Permanente members, more than 50 percent occur over phone, email or video.

Video visits in particular are quickly becoming a popular method among members for handling routine, nonurgent care.

Kaiser Permanente introduced video visit technology in 2014. Today, our members and their care providers have the ability to complete appointments from anywhere, at any time. (Appointment types and availability, and how they can be scheduled, currently vary by region — but we are improving our virtual offerings every day).

videovisitBecause doctors have access to members’ electronic medical record, they are connected to a complete picture of their health. The video visit details are then documented in the patients’ medical records for future reference.

According to a recent study by Kaiser Permanente’s market research team, members:

  • like video visits and see convenience and time-savings as key benefits
  • prefer video visits over telephone visits
  • believe video visits are most appropriate for minor ailments
  • expect discussions with doctors to be more limited in scope compared to an office visit

Snapshot: Colorado

For Jan Ground, director of virtual care for Kaiser Permanente in Colorado, the mission is clear: “We have to meet members where they want to consume services.”

The goal in Colorado, Ground says, is to provide Kaiser Permanente members with video visits with their own doctor, no matter the department or specialty. Depending on demand and schedules, it can sometimes take few days to schedule an in-person appointment that works for the member and care provider, but with video visits, appointments are available within 24 hours — and sometimes as soon as one hour from scheduling.

This flexibility benefits all concerned: Video visitors receive more immediate attention, and physicians can see those who prefer in-person appointments much sooner. Plus, care providers are generally able to see a patient’s home environment and take that into account when creating a care plan.

Of course, video visits aren’t the only way KP physicians in Colorado provide care virtually — they offer phone visits, online chat consultations, and e-visits, in which patients with common and minor ailments, such as sinus issues or stomach problems, can fill out a questionnaire and receive advice based on their answers.

Without doubt, the trend toward virtual care will continue. And with the ongoing improvements Kaiser Permanente is making to kp.org and our mobile app, it will be even easier for our members to access care, when, where, and how they want it.

The Future of Care Delivery

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You walk in, verify at a kiosk that you’ve already checked in and paid, plug in your laptop at the charging station, and soon get a text that it’s your turn. No — you’re not at Starbucks — you’re at Kaiser Permanente’s new Signal Hill Medical Office in Southern California for your medical appointment.

Signal HillSignal Hill exemplifies Kaiser Permanente’s most recent effort of evolving its care model to better integrate into members’ lives.

“Granddad’s medical office building doesn’t cut it anymore,” said Don Orndoff, senior vice president, National Facilities Services.  “We’ve all now become accustomed to the Amazon and Uber experience and that’s our new expectation.”

The medical office of the future at Kaiser Permanente means harnessing design, technology and workflow to create an intuitive and convenient experience for members and care teams. It also means developing a much more agile and flexible environment that meets the evolving technology and service needs of those increasingly tech-savvy members and care teams.

Convenience and care under one roof

Signal Hill opened to Kaiser Permanente members on June 29, 2016, and its sleek architectural design doesn’t disappoint. But it’s the convenient technology features and efficient spaces inside that really impress. When you walk inside the building, you enter into the “public square.”

Since members have the option of checking in and handling their copayments at home, a quick visit to the kiosk allows them to take advantage of a number of options available to them in the public square. They can engage with others at the community table or use computers at the docking station. Or, they can decompress in a quiet spot on the upstairs “porch.” In fact, members can use their time wherever they wish because once the provider is ready, the member will receive a text message.

At the pharmacy, there is also no need to wait around. You’ll receive a text when your medication is ready.

signalhill2The exam rooms don’t look traditional either. Instead of the long, awkward exam table and steel chairs, there’s a comfortable reclining chair and a couch for family seating. The care team also uses hand-held tablets, which is not only easier for them, but avoids having the member stare at the back of a big computer monitor. On the wall, there’s a large monitor for virtual visits or patient education programs.

Read more of this story here.